抗着丝点抗体与抗核抗体在原发性胆汁性肝硬化的临床意义  

The clinical significance of anti-centromere antibody and antinuclear antibody in primary biliary cirrhosis

作　　者：王培之[1] 华文浩[1] 刘颖[1] 

机构地区：[1]首都医科大学附属北京地坛医院检验科,100015

出　　处：《北京医学》2012年第6期441-444,共4页Beijing Medical Journal

摘　　要：目的探讨抗着丝点抗体(ACA)在原发性胆汁性肝硬化(PBC)中的临床意义。方法收集67例抗线粒体抗体(AMA)和AMA-M2阳性PBC患者的临床资料,检测其抗核抗体(ANA)和ACA、生化、凝血酶原活动度(PT)及免疫指标等。结果 ACA阳性组27例,ACA和ANA均阴性组40例。ACA阳性组脾肿大的发生率高于ACA和ANA阴性组(77.8% vs. 40.0%,P=0.002)。ACA阳性组黄疸的发生率、血清总胆红素(TBIL)水平、IgG水平和IgG异常升高率明显低于ACA和ANA阴性组[25.9% vs. 55.0%,P=0.018;(41.62±45.96)μmol/L vs. (88.49±99.13)μmol/L,P=0.012;(13.90±2.75)g/L vs. (18.32±6.34)g/L,P=0.002;29.4% vs. 60.0%,P=0.044]。两组在其他临床表现、肝功能及其他免疫指标的差异无统计学意义。结论单一ACA阳性PBC患者疾病的进展比ACA和ANA阴性患者更加隐匿。ACA阳性PBC患者是PBC的一个特殊类型。Objective To investigate the clinical significance of anticentromere antibody（ACA） in patients in primary biliary cirrhosis（PBC）.Method Sixty-seven cases of anti-mitochondrial antibody（AMA） and AMA-M2 positive PBC patients were collected with the clinical data.Antinuclear antibody（ANA）,ACA,biochemical indicator,prothrombin activity（PT） and the immune index were detected.Results There were 27 cases in single ACA positive group,and 40 cases in both ACA and ANA negative group.The incidence of jaundice,the levels of serum TBIL,IgG and the rate of abnormal elevation with IgG in ACA positive group were higher than those in ACA and ANA negative group [25.9% vs.55.0%,P = 0.018;（41.62±45.96）μmol/L vs.（88.49±99.13）μmol/L,P = 0.012;（13.90±2.75）g/L vs.（18.32±6.34）g/L,P =0.002;29.4% vs.60.0%,P= 0.044].There were no significant differences between the two groups in other clinical manifestations,liver function and other immune index.Conclusion Disease progressions of the single ACA positive patients with PBC are much hidden than those of the ACA and ANA-negative patients with PBC.The ACA positive group of patients with PBC is a special type of PBC.

关 键 词：肝硬化 胆汁性 抗着丝点抗体 

分 类 号：R575.2[医药卫生—消化系统]